Category: pandemic

Discussion thread

August 1, 2021 • 9:15 am

Once again there’s nothing I see that stimulates me to write; am I running dry, is there no news of note, or is everything happening just a reprisal of what I’ve commented on before? At any rate, there’s no need for me to write when I am not compelled to say something, so perhaps we can have a discussion instead. (I’ll put up a photo-and-video post of Botany Pond’s ducks and turtles later.) But there are things we can discuss.

Here are a few subjects, but you needn’t limit yourself to these.

A lot of people, and not just right-wingers, are complaining about the rapid changes in recommendations by the CDC about how to behave during the pandemic. While the vaccination recommendation remains strong and in place, lockdown and especially mask recommendations seem to change daily. Is this just what happens when what we know about the new variants and about science changes over time, or is the CDC itself conflicted about what to do and say, perhaps because there’s a conflict between their medical opinions and how Americans would react against more restrictions? On the NBC Evening News yesterday, CDC director Rochelle Walensky was asked if she thought there should be the “government should mandate the vaccine on a federal level”.  They were asking her opinion, but she punted, saying that the administration was looking into it, and later issued the following “clarification”:

Even so, I don’t know what she’s talking about. My own view is to act like I did last year and earlier this year: wear masks indoors, stay 6 feet away from people who I don’t know are vaccinated, and wash my hands a lot. And I’ll get a booster. I am less fearful than I was last year, as we know the vaccine strongly protects you against death or hospitalization. But all over America, people are resistant to new lockdowns. Given the data on the delta variant, and the claim that it can accumulate in the nasal passages of those who have been fully vaccinated, and that those people can infect other people—even other vaccinated people—is the federal government acting properly? (I assume people will agree that some state governments have their heads in the sand.)

After missing a vault and falling on her back in practice, gymnast Simone Biles has apparently pulled out of all team and individual events. This is surely wise, as she seems to have lost either her confidence or sense of where she was in the air. She said she had the “twisties”. Apparently this is not uncommon among gymnasts. As Time Magazine reports:

And every gymnast can relate. Biles has since said that the combination of mental stress and pressure leading up to the Olympics have affected her confidence. But, more importantly, she felt a disconnect between her mind and body; her body was no longer doing what she wanted it to. Whatever the trigger, gymnasts call this the “twisties.”

“If you say ‘twisties’ every gymnast knows what you’re talking about,” says Jordyn Wieber, member of the 2012 Olympics gold medal team and now head women’s gymnastics coach at the University of Arkansas. “It’s something all gymnasts experience at one time or another.”

. . .What causes the twisties varies from gymnast to gymnast—sometimes, they can be triggered if the gymnast is training different twisting skills at the same time, for instance going back and forth between double twisting elements, one-and-a-half twists, and triples. Stress could contribute to them. Or they can just descend out of the blue for no reason.

For Biles, they occurred on the world’s biggest stage, and the look of concern everyone saw on her face makes sense. “She is doing some of the most difficult skills in the entire world, and if you’re not mentally in a great place, or have the twisties, then that can be a matter or life or death,” says Wieber. “One wrong landing, or landing on your neck, could be really, really dangerous.” Biles has four skills named after her on the vault, floor and beam, including the daring triple-twisting double back flip on floor exercise.

Biles has been answering questions on Instagram about the twisties, and it’s clear she is experiencing the classic signs. “Literally cannot tell up from down. It’s the craziest feeling ever, not having an inch of control over your body,” she wrote. “what’s even scarier is since I have no idea where I am in the air, I also have NO idea how I’m going to land. or what I’m going to land on. Head/hands/feet/back…”

It’s clearly laudable that Biles pulled out of competition, as gymnasts with the “twisties” who haven’t done so have wound up as quadraplegics. And her personal behavior has been exemplary, supporting her teammates down the line. Likewise with her coaches and teammates, who fully support her decision and have shown her a lot of affection.

What worries me is not Biles’s or her teammates’ behavior, but the reporting that has analogized the “twisties” with serious mental illness: the kind of depression, for example, that still affects swimmer Michael Phelps and perhaps Naomi Ozaka. Biles in fact seems to be receiving support for going public with being mentally ill, something that she hasn’t done!

What’s good about the Phelps/Ozaka cases is that they’ve led to the de-stigmatization of mental illness and the recognition that it’s more frequent than people think. But is there a downside with conflating nerves, “twisties”, or a loss or proficiency with mental illness? I think so, but want to hear from readers.

Finally, speaking of the Olympics, is there too much jingoism evinced in the coverage? Every night on the reports, nearly all the coverage is about Americans, with the inevitable chart showing how the countries rank in terms of medals, like this one:

I know you can’t get rid of patriotism completely, but it seems that this concentration on countries is inimical to the spirit of the Olympics, where politics isn’t supposed to matter. And I suspect there are a lot of fantastic athletes from other countries with stories as compelling as, or more so, than those of athletes like Katie Ledecky and Sunisa Lee. Where are their stories?

Well, those are three suggestions, but any topic is open. As always, I regard such discussions as failures if we get fewer than fifty comments (it’s a peccadillo of mine), so weigh in.

Is now the winter of our discontent?

July 31, 2021 • 12:15 pm

I was talking to a friend last night who told me how worn out she was from the pandemic—and she has family all around her, including two grandkids. That made me realize how worn out we all our from our more-than-a-year sequestration. Nobody has been immune.

And now the specter looms of yet another lockdown and mask festival, this time caused by the delta variant of Covid, which can not only infect those who are doubly vaccinated, but can live in huge numbers in their nasal passages and infect other vaccinated people.  A huge number of Americans are resisting not only getting vaccinated, but also to wearing masks. Some yahoo governmental officials have declared that they won’t even consider mask mandates. All of this this presages another tough time this fall and winter. These are my predictions, and I dearly hope I’m wrong.

a.) There will be another surge in infections, which in fact is starting now, and breakthrough infections will start happening with the vaccinated. Other variants may arise even more dangerous than the delta. Kids will start getting the virus.

b.)  Booster shots will be instituted by the fall, and the smart folks will get them. In fact, I think we’ll need at least an annual COVID shot because immunity is wearing off faster than many thought.

c.) Perhaps more Americans will start wising up about vaccination and masking, but not enough of them. On Thursday heard four healthcare workers on the NBC Evening News explain why they didn’t want to get vaccinated. Healthcare workers! One said she didn’t trust the CDC. Another, confronted with the “facts” about vaccine efficacy, said she didn’t believe them.

d.) We will start having more lockdowns and mask mandates, and people, worn out from the last ones, will be even more resistant than before. Eight of the fifty states have indoor mask mandates. As of now, only two of of them (Nevada and Hawaii), as well as Washington, D.C., include the vaccinated. But of course we know now that the vaccinated can not only get infected, but spread the virus. (The just don’t get as sick as the unvaccinated.)

d.) As schools start to open, and the concert/entertainment festivals start, superpreader events will occur.  (The giant Lollapalooza Music Festival is going on right now in Chicago. You can get in if you wear a mask, but if you’re unmasked, you’re required to show a negative Covid test in the last three days or your vaccination card. But which masked people will  be keeping them on in the huge crowd?)  This all will lead to more lockdowns and other restrictions.

e.) Schools will open soon. Many kids have not been vaccinated, and nobody under 12 is even eligible. What with the Delta variant about, which makes younger people sicker than the previous variants, proper social distancing, air filtering, and mask wearing are essential for live classes. Everybody connected with school is sick of virtual teaching, so schools will desperately try to stay open “live”. This will cause problems, and many schools may go back to virtual classes.

The upshot: the “Summer of freedom” we all expected is dissolving fast, and I suspect we’re facing another wearing Fall and Winter of Restrictions. Many more people in the U.S. will die than would have had they gotten their jabs, and we’re all in for more restrictions, masking, and travel bans.

In short, it’s going to be tough until well into 2022. Such is my prediction, which is mine. It’s depressing. And you don’t have to be a rocket scientist to see it coming.

 

The Delta variant of COVID-19 (caption from NPR), which is more dangerous because it proliferates faster in the respiratory tract and reaches higher numbers: 1,000 times higher than previous variants.

The numerals in this illustration show the main mutation sites of the delta variant of the coronavirus, which is likely the most contagious version. Here, the virus’s spike protein (red) binds to a receptor on a human cell (blue). Juan Gaertner/Science Source

Did the Covid-19 virus come from a Wuhan lab? It’s looking increasingly likely.

June 4, 2021 • 1:15 pm

You surely remember last year when the “conspiracy theory” was broached that the coronavirus, which was thought by nearly all the media to have come from a Wuhan wet market, might have actually come from a virology lab in Wuhan, with some even suggesting that it might have been released on purpose.

Well the “deliberate release” scenario is dumb, since how could one contain an easily-spread virus targeted at an enemy? But the “accidental release” theory is gaining more and more credibility, with the Biden administration deciding to launch its own investigation. The story below, from Newsweek (yes, a conservative site), recounts how a group of amateur Internet sleuths pieced together from publicly available data what is the most likely story: an accidental release of a virus stored in the Wuhan Institute of Virology (WIV). That virus seems to have come from a Chinese cave in which 3 men shoveling bat guano died in 2012, and died from a virus that was remarkably similar to the coronavirus responsible for the pandemic.

It’s thus likely that the Chinese repeatedly lied about the origins of the virus and the U.S. government, suckered in, didn’t do due diligence in following up. After all, if a bunch of amateurs can piece together this tale (and I emphasize that we don’t know if it’s true for sure), why couldn’t the government?

Click screenshot to read the story:

It was a group of amateurs, following the lead of an young Indian called “The Seeker,” who determined that the sequence of the pandemic virus was almost identical to that of the virus stored in the WIV (they managed to get the latter sequence), and that that virus was likely the one who killed the three men nine years ago. They also found out, through diligent labor, that the WIV was actually studying the virus despite their denial, and had made seven trips to the guano mine to collect samples. The amateurs found grant proposals from the WIV, which was apparently testing the infectivity of the collected viruses, possibly with the hope of producing a vaccine against them.

As Newsweek notes, “The ongoing effort to cover this up implies that something may have gone wrong.” What went wrong, if the story is indeed true, might never be known, as the Chinese either might not know themselves and at any rate haven’t been exactly forthcoming about what they do know. Now professional journalists and epidemiologists are on the case, so we should get some answers—at least about whether the virus came from the WIV.

The episode of course makes China look bad (the article is replete with the WIV’s and Chinese government’s lies), but it also makes the U.S. look bad. It makes the press look bad: newspapers and websites had to go back and change months-old headlines that the lab-escape theory had been debunked. And it makes science look bad. To dismiss a theory without having investigated it first, and dismiss it so, well, dismissively, is only going to make people trust scientists less.  It’s even worse when you realize that had the Chinese been open about what they were doing, and were studying the sequences of viruses related to the pandemic organism, a vaccination might have been developed—or at least been in the works years before the outbreak.

Again, this is just a theory, but it’s a theory that’s become so plausible that nobody dismisses it as lunacy any more, and our own government is taking it seriously. If it turns out to be true, what will be the upshot? We’ll know to trust Chinese assurances even less (apparently the U.S. government was too credulous), and perhaps this can ensure more cooperation with the Chinese in future cases. But I wouldn’t count on it. At least we know that science works best when it’s at its most open.

At any rate, you owe it to yourself to read this fascinating amateur detective story.

h/t: Luana

Why evangelical Christians fear Covid vaccination

May 16, 2021 • 11:30 am

It’s pretty well known that some of the people most hesitant to get vaccinated against Covid are evangelical Christians. In the NYT article below (click on screenshot), two of them do a good thing, urging their fellow evangelicals to get their jabs. Here’s a plot showing that while Jews and white Catholics are pretty down with getting their shots, Protestants, particularly white evangelical and Hispanic ones, are resistant, with fewer than half being “accepters”. (Evangelicals are also less likely to wear masks.)

Why is this? Chang and Carter explain:

The decision to get vaccinated is essentially a decision to trust institutions. Many people do not understand the vaccines’ scientific complexities, regardless of religion. That means getting immunized is a decision to trust “them” — the constellation of scientific and government institutions offering assurances that the vaccines are safe and effective.

But American evangelicals are historically prone to ambivalence toward dominant secular institutions. In fact, a posture of critical evaluation is built into the fabric of our faith. Evangelicals interpret Jesus’ teaching that his followers are in the world but not “of the world” (John 17:16) to mean we should engage with secular institutions with a certain measure of wariness. Some amount of caution is healthy for all communities, not just for evangelicals. No institution is infallible, and critical thinking can be a civic virtue.

What ever happened to “render unto Caesar the things that are Caesar’s“? For surely the vaccine is Caesar’s!


But there are other reasons as well:

Unfortunately, in recent years, the evangelical approach to engaging with secular institutions has morphed from caution into outright fear and hostility. Three forces have exploited this inherent ambivalence toward secular institutions. First, conservative media has mastered the art of sowing evangelical suspicion of the establishment to increase ratings. Second, politicians — some Christian and some not — have used evangelicals’ distrust of so-called elite institutions to gain our votes. Third, conspiracy movements such as QAnon and antivaccine campaigns have targeted evangelicals, conjuring fictional enemies intent on destroying our values and, in the case of the vaccines, our actual bodies. All of these forces shape how large segments of the evangelical community perceive the Covid vaccines.

In our vaccination outreach, evangelicals have told us they’re suspicious of the shots for a variety of reasons. Many worry that the development process was rushed, that the vaccines contain a microchip or that they are the “the mark of the beast,” a reference from the Book of Revelation that some Christians associate with a future Antichrist figure. A sharpened distrust of institutions underlies these fears.

But did you note the explanation above, which I’ll repeat:

In fact, a posture of critical evaluation is built into the fabric of our faith. Evangelicals interpret Jesus’ teaching that his followers are in the world but not “of the world” (John 17:16) to mean we should engage with secular institutions with a certain measure of wariness. Some amount of caution is healthy for all communities, not just for evangelicals. No institution is infallible, and critical thinking can be a civic virtue.

You can already see the dissonance here, and I’ll quote reader Philip, who sent me this link, who has a few questions:

As if critical thinking and “critical evaluation” (based on rational evidence and the desire to acquire it) constitute the foundation of evangelical skepticism.  Does he include “The Church” in his “No institution is infallible . . . .”?  Would he tell evangelicals that?  And when is critical thinking not a civic virtue?

The first sentence, “In fact, a posture of critical evaluation is built into the fabric of our faith” evoked a guffaw, if not a horse laugh. True critical evaluation by evangelical Christians would lead to the disappearance of the faith, if for no other reason than no Christian, evangelical or otherwise, if sufficiently critical, could demonstrate that their religion—as opposed to the gazillion others on the planet—is the right one. And if you don’t choose the right one, you’re going to fry for eternity.

Kudos to Chang and Carter for trying; theirs is an admirable though an uphill battle. But they really shouldn’t have claimed that critical evaluation and caution are healthy and “built into the fabric of their faith.”

“Here we believe science is real”. . . . well, not everyone

May 11, 2021 • 1:15 pm

Ah, yes, here’s the sign one sees everywhere in good liberal communities. Notice the phrase at the top:

And yet, as “science” now tells us we can begin in many cases to resume some aspects of our pre-pandemic life, Emma Green at The Atlantic tells us that there are some liberals apparently so wedded to the provisions of the lockdown that they can’t let go of any of them.

I plead partially guilty here. I still wear a mask when walking outside, even when I’m not near anybody, as when I’m walking along the lakefront.  And yes, I’ve had my two Pfizer jabs. When I pass someone on the street with my mask pulled down, I pull it up over my mouth and nose.  Of course they don’t know that I’m vaccinated, so to me that’s okay—it reassures them. But the fact is that the chance that I could infect anyone is pretty close to zero percent, unless I’m an asymptomatic carrier. Still, even friends who have been vaccinated are wary of having me over—for no good reason I can determine. (Maybe I’m odious!) Click on the screenshot:

A few excerpts:

Lurking among the jubilant Americans venturing back out to bars and planning their summer-wedding travel is a different group: liberals who aren’t quite ready to let go of pandemic restrictions. For this subset, diligence against COVID-19 remains an expression of political identity—even when that means overestimating the disease’s risks or setting limits far more strict than what public-health guidelines permit. In surveys, Democrats express more worry about the pandemic than Republicans do. People who describe themselves as “very liberal” are distinctly anxious. This spring, after the vaccine rollout had started, a third of very liberal people were “very concerned” about becoming seriously ill from COVID-19, compared with a quarter of both liberals and moderates, according to a study conducted by the University of North Carolina political scientist Marc Hetherington. And 43 percent of very liberal respondents believed that getting the coronavirus would have a “very bad” effect on their life, compared with a third of liberals and moderates.

. . . . Even as the very effective covid-19 vaccines have become widely accessible, many progressives continue to listen to voices preaching caution over relaxation. Anthony Fauci recently said he wouldn’t travel or eat at restaurants even though he’s fully vaccinated, despite CDC guidance that these activities can be safe for vaccinated people who take precautions. California Governor Gavin Newsom refused in April to guarantee that the state’s schools would fully reopen in the fall, even though studies have demonstrated for months that modified in-person instruction is safe. Leaders in Brookline, Massachusetts, decided this week to keep a local outdoor mask mandate in place, even though the CDC recently relaxed its guidance for outdoor mask use. And scolding is still a popular pastime. “At least in San Francisco, a lot of people are glaring at each other if they don’t wear masks outside,” Gandhi said, even though the risk of outdoor transmission is very low.

Believe me, I have seen those glares, even when I’m six feet away from someone and I’m not wearing a mask. It’s almost a form of mask-shaming. In fact, it IS a form of mask-shaming.

Green recounts the tale of Somerville Massachusetts, a good liberal neighbor of Cambridge, and a place where “SCIENCE IS REAL.” Except when it comes to reopening schools. Lots of work and research, including installation of UV sterilization units and automatic toilet flushers, determined that Somerville schools could now re-open. But they won’t, because, well, “maybe science isn’t real.”  Finally they opened kindergartens and middle schools, but high schools are still locked tight. People are afraid because they’re afraid that science isn’t real.  Of course the risk is not 0%, but it’s good enough for the experts, as is the CDC recommendation that dining without a mask in a restaurant, for people who are fully vaccinated, is fine with proper precautions. My own physician tells me this. Why is Dr. Fauci resistant?

No, some people are just wedded to the idea that safety trumps everything, which isn’t realistic in a world where there are risks.  I understand this, and do not dislike those who cling to their masks and rituals. But it’s very odd that those of us who waited for vaccinations to free us in some ways are now reluctant to take advantage of that freedom. As Green says:

Policy makers’ decisions about how to fight the pandemic are fraught because they have such an impact on people’s lives. But personal decisions during the coronavirus crisis are fraught because they seem symbolic of people’s broader value systems. When vaccinated adults refuse to see friends indoors, they’re working through the trauma of the past year, in which the brokenness of America’s medical system was so evident. When they keep their kids out of playgrounds and urge friends to stay distanced at small outdoor picnics, they are continuing the spirit of the past year, when civic duty has been expressed through lonely asceticism. For many people, this kind of behavior is a form of good citizenship. That’s a hard idea to give up.

Effectiveness of coronavirus vaccines

May 2, 2021 • 11:00 am

My doctor, Alex Lickerman, has put up post #13 in his continuing series on the medical science of coronavirus and the pandemic. This short but informative post (click on screenshot below) deals with a question we all have:

First, the effectiveness. Alex summarizes numerous studies showing how effective a vaccine is. Remember, though, what that number, expressed as a percentage, means. If a vaccine is 95% effective, it means that in a situation in which a certain percentage of people get infected, say 30%, then the chance you will get in infected is (100% – 95%) X 30%, or 1.7%.  Note that this does not mean that your chance of getting infected is 5%: it’s lower than that because not everybody gets infected when they’re not vaccinated.

Here are some effectiveness estimates taken by Alex from the literature:

Single dose Pfizer: 70%
Double dose Pfizer: 85%
Single dose Pfizer and Modern considered together, single dose: 80%
Double dose   ”            ”                   ”                 ”            double dose: 90%
The two above figures are also the same in another study not specifying vaccination

The 80%-90% holds for both symptomatic and asymptomatic infections; this means that yes, you can be an asymptomatic carrier if you have been fully vaccinated, but the chances are very small.

 Pfizer and Moderna combined (both mRNA vaccines): effectiveness: over 96%

Now remember again what these figures mean, because people get that meaning wrong all the time. Here’s one example I quote from the article:

A CNN article was skeptical of this data, arguing that “real-world studies of the Pfizer-BioNTech and Moderna vaccines show they are only 90% protective against the coronavirus, not 95% as reported in clinical trials. Translated into reality, that means for every million fully vaccinated people who fly, some 100,000 could still become infected.” Importantly, this is not what 90 percent effectiveness means! Ninety percent effectiveness means the vaccines reduce the rate of infection by 90%. To calculate a person’s absolute risk of getting infected after having been vaccinated, you have to start with the base rate of infection, which is different in different contexts. It would be true that “for every million fully vaccinated people who fly, some 100,000 could still become infected” if the base rate of infection for those million people was 100 percent. Yet the highest rate of infection we’ve seen in published contact tracing studies was around 30 percent (for spouses of infected people). This means that post-vaccination rates of COVID-19 infection in the vaccinated population are at most 90 percent less than 30 percent, or 3 percent. And that only if everyone who’s been vaccinated has an infected spouse.

In fact, the CDC reported that, as of April 20, 2021, out of 87 million fully vaccinated people there were only 7,157 breakthrough infections (0.008 percent), only 498 hospitalizations (0.0006 percent) related to COVID-19, and only 88 deaths (0.0001 percent) related to COVID-19.

Alex’s bottom line:

The mRNA vaccines are extraordinarily effective at preventing both symptomatic and asymptomatic infection and therefore at preventing transmission of SARS-CoV-2. Most importantly, if you’re fully vaccinated, your risk of dying from COVID-19 is 0.0001 percent.

What about the variants?. In answer to the question of whether the vaccines work against the variants, Alex says “yes”, at least for variants currently circulating. He adds that more data are to come.

Here’s Alex’s conclusion, which happens to echo the same conclusions reached by Bari Weiss in a piece published on her site this morning:

CONCLUSION: Given the incredible effectiveness of the vaccines at preventing both symptomatic and asymptomatic disease, and therefore disease transmission, and given that the rates of death from COVID-19 in vaccinated people is 0.0001 percent among all vaccinated people in the U.S. (an analysis that also included the J&J vaccine), if you’ve been vaccinated, we consider it reasonably safe to dine indoors, travel, and gather with even unvaccinated people. Living in the world has, of course, never been risk-free. Yet we can now say that with the advent of effective vaccines against SARS-CoV-2, the risk of living as you did before the pandemic has returned to what it was before the pandemic.

Here’s Weiss’s piece, which I think is free, though I’ve now subscribed. Click on the screenshot:

The hell that India has become

April 29, 2021 • 11:00 am

The Guardian has a “long read” piece by Arundhati Roy, a famous writer who lives in Delhi (you may have read her Booker-Prize-winning book The God of Small Things). If you have any interest in India (or let’s just say “humanity”), it is well worth reading.  Click on the screenshot to do so.

Roy deals with two connected topics, the pandemic that’s now ravaging India (the infection rate may soon rise to half a million per day), and the diffidence of the Modi government, which is corrupt, anti-Muslim and Hindu-centric, and absolutely without empathy.

I’ve written about both these things before, but Roy, being “on the ground” in Delhi, has a horrific account of what it’s like to live in the center of the maelstrom. She notes that deaths and infections are likely to be grossly underreported given the largely rural population of India, and that 78% of healthcare in urban areas and 71% in rural areas is handled by the private sector, which means that the poor are simply unable to afford healthcare, much less vaccinations or oxygen. The black market that has sprung up around these things, while typical of India in a desperate situation, is further hitting the poor, and, as you may have seen from photographs, the poor are being refused hospital admission (or asked to bring their own oxygen tanks), or are left to die on the sidewalks. There are so many bodies that there’s a shortage of wood to cremate them.

(From Guardian) People with breathing problems caused by Covid-19 wait to receive oxygen in Ghaziabad. Photograph: Adnan Abidi/Reuters

The Modi government under the Bharatiya Janata Party (BJP) isn’t positioned to help, either materially or psychologically. The fact is that Narendra Modi is basically an evil man—the kind of man who encourages or allows Hindus to kill Muslims. I consider him even worse than Trump, since he doesn’t even pretend to care about the plight that’s destroying India. Yet he’s still too popular to be deposed.  And while earlier he assured the world that India, the world’s second most populous country, had the virus under control, that proved to be untrue.  It’s clear that, like me, Roy is a bitter opponent of Modi and his minions, but you can read about that in the article. I’ll give just one quote:

As this epic catastrophe plays out on our Modi-aligned Indian television channels, you’ll notice how they all speak in one tutored voice. The “system” has collapsed, they say, again and again. The virus has overwhelmed India’s health care “system”.

The system has not collapsed. The “system” barely existed. The government – this one, as well as the Congress government that preceded it – deliberately dismantled what little medical infrastructure there was. This is what happens when a pandemic hits a country with an almost nonexistent public healthcare system. India spends about 1.25% of its gross domestic product on health, far lower than most countries in the world, even the poorest ones. Even that figure is thought to be inflated, because things that are important but do not strictly qualify as healthcare have been slipped into it. So the real figure is estimated to be more like 0.34%. The tragedy is that in this devastatingly poor country, as a 2016 Lancet study shows, 78% of the healthcare in urban areas and 71% in rural areas is now handled by the private sector. The resources that remain in the public sector are systematically siphoned into the private sector by a nexus of corrupt administrators and medical practitioners, corrupt referrals and insurance rackets.

Healthcare is a fundamental right. The private sector will not cater to starving, sick, dying people who don’t have money. This massive privatisation of India’s healthcare is a crime.

The system hasn’t collapsed. The government has failed. Perhaps “failed” is an inaccurate word, because what we are witnessing is not criminal negligence, but an outright crime against humanity. Virologists predict that the number of cases in India will grow exponentially to more than 500,000 a day. They predict the death of many hundreds of thousands in the coming months, perhaps more. My friends and I have agreed to call each other every day just to mark ourselves present, like roll call in our school classrooms. We speak to those we love in tears, and with trepidation, not knowing if we will ever see each other again. We write, we work, not knowing if we will live to finish what we started. Not knowing what horror and humiliation awaits us. The indignity of it all. That is what breaks us.

Oh, and a cry for help:

The crisis-generating machine that we call our government is incapable of leading us out of this disaster. Not least because one man makes all the decisions in this government, and that man is dangerous – and not very bright. This virus is an international problem. To deal with it, decision-making, at least on the control and administration of the pandemic, will need to pass into the hands of some sort of non-partisan body consisting of members of the ruling party, members of the opposition, and health and public policy experts.

As for Modi, is resigning from your crimes a feasible proposition? Perhaps he could just take a break from them – a break from all his hard work. There’s that $564m Boeing 777, Air India One, customised for VVIP travel – for him, actually – that’s been sitting idle on the runway for a while now. He and his men could just leave. The rest of us will do all we can to clean up their mess.

No, India cannot be isolated. We need help.

And here’s how to help: consult these articles, which give many links about how and where to give:

New York Times

Washington Post

Remember, India is the world’s biggest democracy, and despite the execrable government, the country and its people need our help. Please donate if you can.
h/t: David